Vicarious Surgical at H.C. Wainwright: New Robotic Frontiers

On Wednesday, 10 September 2025, Vicarious Surgical (NYSE:RBOT) unveiled its strategic vision at the H.C. Wainwright 27th Annual Global Investment Conference. The company, under the leadership of newly appointed CEO Stephen From, presented an ambitious plan to revolutionize the robotic surgery landscape. While highlighting the innovative aspects of their minimally invasive platform, From acknowledged the challenges ahead as they aim to penetrate the largely untapped market of non-robotic surgical procedures.

Key Takeaways

• Vicarious Surgical targets the 82% of U.S. surgeries that are currently non-robotic, focusing initially on ventral hernia repair.
• The company’s technology differentiates itself with features like decoupled actuators, intra-abdominal motion, and AI capabilities.
• A significant milestone was achieved with the first system build under a full quality management system, with a second build completed in August.
• The company plans to achieve 100% function and safety testing by mid-2025, followed by design lock and commercialization.
• Vicarious Surgical aims to capture a 1% share of the total addressable market (TAM), potentially generating $77 million in revenue.

Financial Results

• Total Addressable Market (TAM): 82% of U.S. surgical procedures are non-robotic.
• Revenue Potential: Capturing 1% of the TAM could yield approximately $77 million, based on the average disposable revenue of $1,800 per procedure.

Operational Updates

• System Development Milestones:

- First system build completed under full quality management in April.

- A second system with the same requirements was built in August, showing increased efficiency.

- Function and safety testing is currently at 63%, with a goal of reaching 100% by mid-2025.

- Design lock is targeted for the end of 2025, setting the stage for clinical trials and commercialization.

Future Outlook

• Commercialization Strategy:

- Initial focus on ventral hernia repair to demonstrate system capabilities.

- Targeting the non-robotic segment of the surgical market.

- Differentiation from competitors like Intuitive Surgical by addressing existing platform limitations.

- Clinical trials and commercialization are expected to follow the design lock by the end of 2025.

Q&A Highlights

• Ventral Hernia Indication: Chosen to showcase the system’s ability to access challenging areas like the upper abdomen.
• Market Access Strategy: Emphasizes the system’s advantages over current robotic platforms, appealing to surgeons who prefer open surgery capabilities.
• Single-Arm Design: Offers flexibility in trocar placement and avoids collision issues common in multi-arm systems.

Readers are encouraged to refer to the full transcript for a detailed account of the conference discussions.

Full transcript - H.C. Wainwright 27th Annual Global Investment Conference:

Unidentified speaker, Unidentified: Vicarious Surgical. To talk about Vicarious Surgical, we have Stephen From, CEO from Vicarious. Vicarious is a medical device company that is developing a robotic surgical system. To talk more about Vicarious, we have Stephen here.

Stephen From, CEO, Vicarious Surgical: All right, thank you. Good morning, everybody, and thank you for sticking around to the last day and coming to the presentation. I’m just going to preface this by saying I’m new here. I’m four weeks into being CEO of the company, okay? Forgive me if there’s a few mistakes as I go through the presentation, but it is my presentation. I built this specifically for the conference. As you can see, we’re a minimally invasive platform. It’s robotic-assisted surgery. Why do we exist? The reason we exist is because the current platforms have some real limitations. The whole idea around the founders’ vision was twofold. One was, could there be a system which would be easier for surgeons to use, which would help increase adaptability?

The second one is, could we create, could we design and develop a system that would provide not just better vision and perspective of the area that we want to work in, but also full accessibility? How you do that is by actually doing open surgery. Open surgery, you have full movement, you have full accessibility, you have full vision perspective. Is there a way to develop an actual minimally invasive platform to have that same result? That was the whole purpose of Vicarious Surgical. When you think about the current systems that exist right now, and there’s obviously one that dominates, this current system was designed as a general purpose minimally invasive platform, okay? What’s really interesting is where we’re seeing the majority of adoption for the system is in one surgical procedure, prostatectomy. What’s interesting is it wasn’t designed for prostatectomy.

As I said, it was meant to be a general purpose. The point is, because of some of the limitations of the systems, as I just mentioned to you, the limitations include the rigidity of the actual arms that go through the trocar or the openings, the incisions, the actual ability to have full freedom of motion once you’re in that space you want to work in, the ability to have full access to visual perspective. What’s interesting is that when you look at a surgical procedure where that doesn’t matter as much, prostatectomy, you can check all the boxes. One of the main things you’re looking for in prostatectomy is really just being able to reduce tremor and really having stable visualization. Even those rigid arm platforms have that ability. When you go outside of prostatectomy, the adoption of the robotic platforms drops precipitously.

Now we’re going to talk about ventral hernia because that’s going to be the first indication that we’re seeking approval for. You can see here, when you take a look at the bars, the bars themselves represent the number of procedures annually, and then the dark part there is the % of adoption. This is coming from a sample from one of the hospital systems that we work with, and that’s where this information came from. You can see how much adoption of the robotic platforms drops outside of prostatectomy. This here is just a little cartoon to show you. Prostatectomy, again, I’m using the prostate as the example here because it’s where you see the highest adoption of these other platforms. The ability to triangulate, to be able to understand exactly where to put the trocars, that’s pretty straightforward for this procedure.

All you really need are the rigidity of the arms doesn’t matter. You’re going straight in, you’re going straight to a target. You just want to reduce the tremors. Ours, as you can see on the right, which looks a little bit more exciting, we can do the prostatectomy, but the difference, the real main difference here is our robot, and you’re going to see this in a couple of slides later, everything that all the movements, all the work is being done on the inside of the abdomen. Whereas with the other systems, the majority of the arms are actually on the outside of the body, and there’s the opportunity for them to even hit each other. These arms can be difficult. Here’s an example of what our capital equipment looks like. Just like the other platforms, we have two major pieces of capital equipment. They look similar.

They’re not the same as our competition. We’ve done some things which we believe will be easier for adoption, the natural motion. We have what’s called the patient cart, which is where you would see the robotic arms, and we have the surgeon console, which looks like it’s a video game cart. This is where the real magic happens. This is our robot here. We have two arms and we have the camera. It’s our technology that allows us to have, we call them decoupled actuators. There’s some other interesting technology as well that gives us this full dexterity. We have nine degrees of freedom of operation or movement here. We can have full anatomical reach. We also have the full visualization, the perspective. We also actually have a self-cleaning camera. Currently, right now, the technician has to pull the camera out and clean it, wipe it clean.

We don’t have to do that. It’s self-cleaning. I show a diagram, it’s a suturing on the right hand, my right hand anyhow. It’s shown because when we’re going after our first indication of ventral hernia, a lot of these hernias are on the upper side of the abdomen. It’s really difficult for the rigid arms to not only have the visual perspective to look upwards, but to also actually do anything in that upward spot. We have full access to that. We have full vision and full access. As I mentioned, where we’re focusing all of our launch at the beginning is going to be intra-abdominal. Within that space, we’re starting with ventral hernia repair.

A lot of the main reason for that is because a lot of those are going to occur on the upper side of the abdomen, where the other platforms really don’t have any easy access. Although you want to suture, you close up, you suture up the hernia, and then you put a mesh around it to give it more support. We’re able to demonstrate that we can suture all around that mesh, no matter where the location of that mesh is intra-abdominally. In a lot of other cases, whether you’re using laparoscopy or whether you’re using these other platforms, they end up having to do what’s called tacking, which isn’t very beneficial. What we see here, even including laparoscopy, just call it open. Subtract out even laparoscopy. 54% of ventral hernia is still done open.

When you start thinking about the whole abdomen and some of the other procedures, not all of them, but here, and we’re just looking at the U.S. market here, not the global market, but just the U.S. market. There’s just over 5.5 million procedures done in the U.S. annually. Out of those procedures, 82% are still non-robotic. That’s not because the surgeons don’t want to use a minimally invasive robotic platform. It’s because of the reasons that I just discussed with you. They just aren’t adaptable for these particular surgical procedures. They have an easier, it’s faster, it’s easier. I got full motion. I got full vision if I just do open surgery.

I know the complications that come with open surgery, but the surgeon has to decide what’s going to be easier for me to actually get the job done versus thinking about the problems that are going to occur post the surgical procedure. If they had a way that they could use a system to do it minimally invasive, of course they would choose. We see that with prostatectomy. We have close to 100% adoption, so clearly they do want to use a minimally invasive system. What’s really interesting though, I just told you 82% are non-robotic just in the U.S., just in this 5.6 million. It’s going to be a huge multiple of that when you go global. Just to prove the point here, just with that 82%, which is about 4.6 million, we have all of that space open to us because of the way we differentiate ourselves.

We’re not a me too. We’re not going after the market share of Intuitive Surgical. We’re not going to play the same game that Medtronic can afford to play now that they have Hugo approved here in the U.S. They have the ability. They have four times the revenue of Intuitive Surgical. They have the ability. They have the depth within the hospitals to go against an Intuitive Surgical with a system that’s very similar to the Intuitive Surgical system. We don’t need to go after that market share, nor could we afford to. We don’t need to play in that game. We can go after the TAM that no one else can play in, and that’s that 82%.

For us to capture just 1% of that white space TAM, that’s going to be a lot easier and cheaper than trying to capture 1% of the existing 18% TAM from Intuitive Surgical and the others. We have the ability to do that. I don’t even think of them as our competition. I’ll let all those companies compete with each other. We’re in a completely different space. I put a slide in here to show you that what really matters to us, and this isn’t even all of it, this is just representative. These are eight items that are really differentiating for us. Three of them are about the movement, the decoupled actuators, the intra-abdominal motion, the nine degrees of freedom instruments. Those are about the motion. Three of those are about the visualization, the perspective, the camera cleaning. You’ve got 360 visualization there.

You’ve got surgeon interface, and you’ve got camera cleaning. We also have some protection around AI and automation, which is in our future. We have a lot of patents to protect what differentiates us, to protect us as we go into this new TAM area that no one else can play in. I put this in here because we have some people that invested in the company early on, people that I think validate what we’re trying to do makes a lot of sense. There’s some on here that I wasn’t allowed to put on because we don’t have permission to put their logos on, but they’re strategic investors from the industry. Okay, that’s the first part, and I still got time. The second part is, okay, this sounds great, Steve. Where are you though with this system?

You know, we’ve been hearing for a long time that you guys are going to get into the clinic and you haven’t over and over again. That’s why I’m here. I told you I’m four weeks into this gig. I’m here so that I can add some structure and get us to the end goal. Where are we starting from? That’s the first thing I needed to understand. What are we starting from? One of the reasons why I joined is because they did a major transition this year from just being an engineering project to actually being a company that has done their first build under control using their full quality management system. We have full traceability, auditability, everything that you want to do as you start to transition into being a company getting ready for commercialization.

That occurred for the first time this April, using our full quality management system. It’s a huge achievement for the company. In order to understand, could we do it again? Now that system that was built, it was done the first time under control, and it didn’t have all the requirements in it. We wanted to get it built and see if we could test the quality management system. That was the main purpose of it, and it did a great job doing that. Using those same requirements that we completed with that first build under control, we wanted to do it again. Can we do it again? Can we learn from the first one? We did that. We built another one in August with the same requirements that we had in that first one. We were able to demonstrate the increase in efficiency. That’s what you want to do.

You want a robust manufacturing system that can be put in place with full traceability, auditability, all those things that the FDA and you want for commercialization. It’s a big step. Where are we today? We get to September now, early September. With that first build, as I mentioned, we didn’t have all of the requirements in place. Having, I don’t care if it’s a simple system or a complex system like ours, doing your first build using your quality management system to test that system, you’re not going to get to full, it’s rare that you get to full 100% of your requirements, whether it be function or safety. What I wanted to understand is where did we end up and where are we right now? Around mid-June, they did a test to see where we were with the function and safety, and we were just under 50%.

We did it again today before I came to the conference, and we’re at about 63%. We’re showing this trajectory. What I needed to get to is 100%. That’s our goal. Without 100%, we’re not going to have a system that we can commercialize. The goal here is, guys, let’s continue on that trajectory and get us to 100%. Our objective here is to reach that point by the middle of next year. Once we’ve done that, we’ve incorporated all of the safety and the function features now under our, all under our control, all under a quality management system. We now are in a place to start moving forward towards the clinic. We call that our production equivalent system. Still haven’t done design lock yet, but we’ve incorporated everything. We’ve got to continue the testing so that we’re not looking to continue to discover what’s going wrong.

That’s what we still need to complete. We’ve got all of the function and safety capabilities, but we haven’t done design lock yet. That’s something that we’re targeting towards the end of next year for design lock. That’s going to be design lock of our production equivalent system under our full quality management system. Now that we’ve done that, now we can start talking about getting in the clinic and getting to commercialization. For a company like this, the main risk should be about adoption, right? It should be the commercialization. There’s less risk in the clinic for this type of product as, you know, if you’ve completed full verification and validation. The clinical trials aren’t like on the drug side. They’re a lot different here. The real risk has become, can you actually complete this development? Can you get full function? Can you get full safety capabilities?

Now that we actually have an anchor, a reference point, which is doing it the first time under the full quality management system, we actually now know how to get to the end. That’s what we’re working on. As I’ve shown you, I’ve shown you a short trajectory, and we’re working our way to that 100%. This middle of next year, getting to full function and safety requirements is a huge inflection point for us. We now know we’ve built that system. Getting to design lock now gives us the confidence that we can start the regulatory verification and validation. There shouldn’t be any more discovery when we’re in that regulatory verification and validation. All of that should be behind us. That’s why I’m not saying we’re going to have design lock at mid-2026.

We’re going to continue to test all the functionality, all the safety, until we know that we have discovered anything that could go wrong. Then we can say we have design lock. I put this little snapshot up here. I’m not in here. Neither is the executive team. These are the people rolling up their sleeves and actually doing the work. It’s a great team. I’ve gotten to know them over the last four weeks, and I got to tell you, they’re very, very impressive. I’m excited to be working with them and to getting to this important milestone. That’s it.

Unidentified speaker, Unidentified: Questions for you, Steve. Your initial indication is going to be ventral hernia, as you stated. Why ventral hernia, and how big of a market is it?

Stephen From, CEO, Vicarious Surgical: I think it’s a good question. I’m only four weeks into this, and we don’t have the Chief Medical Officer here. It was a good question. That’s when I asked him as well, let’s pressure test this. Does it make sense? From what he’s trying to accomplish with this system, the first indication really isn’t about trying to get $20 billion in revenue. It’s about being able to demonstrate we’re not a me too of the other platform systems that are out there. He’s really focused on really wanting to show how easy it is to get the surgeons to use the system. I’m more focused about how easy the ability to have that full visibility and access to the upper abdomen, which no one else really has, which is why we see such a short or low adoptability with the robotic platforms.

Maybe it’s not the largest indication to go after first, but it’s an exciting one to be able to demonstrate the power of what we can do.

Unidentified speaker, Unidentified: As you stated, you know, Intuitive Surgical is there, is a 70,000-pound gorilla in the room. What makes Vicarious confident that you can access the 82% of the TAM that they are not looking at all?

Stephen From, CEO, Vicarious Surgical: I think they want that 80. I think they are looking at it. It’s not that they aren’t looking at it. It’s that their systems aren’t applicable. A combination of learning how to use the system, surgeons wanting to use it with the difficulty of using that system in those procedures. You have some really sophisticated surgeons that really, they can do whatever they want to with that robot. That’s a small percentage of the surgeons out there. You get to the large percentage, which are really good surgeons, but would rather have full capability with an open surgery procedure than the limited capability with that platform. We’re trying to demonstrate we’re, the whole purpose of our company is to fill that space. We’re not going to fill all 82%, right? We don’t need to. It’s so big. As I was saying, 1%. You can do the math.

If you just took a look at the average disposable amount that Intuitive gets, if you just do the math on the revenue and they say how many procedures they did, on average, it’s about $1,800. If we got 1% of that white TAM just in the U.S., using that average, it’s about $77 million. 1%. I don’t need to have all of 100% of that. I don’t need all of that, right? To be a very successful company. We just need to show that we can actually do the job in that space.

Unidentified speaker, Unidentified: The last question from me is, you know, one of the interesting things about Vicarious Surgical is it’s a single-arm robot versus, you know, other systems like Asensus and others who have, you know, at least two or if not three arms. What’s the advantage of having a single arm? There are folks who say like single arm really doesn’t work. There’s been both yes and no on the story. What do you think works?

Stephen From, CEO, Vicarious Surgical: I think I agree their single arms don’t work, not like ours. I mean, they’re taking the same guts of the multi-port and putting it into a single-port platform. What is, like, what’s the point? It doesn’t make sense. They have the hospital reach, they have the depth of relationship with them that, yeah, they can do that. That wasn’t our goal right from the beginning to begin with. I wish I could put us back to that picture there where you see our robot. You’re calling it a single arm, but it has two arms once you get in there and it has its eyes, right? The beauty of it is, it looks like a single rod going through the trocar. That’s the beauty of it. Whereas on the other side of the coin, you can have four or five arms going through four or five trocars.

If you don’t get the trocar in the right prostatectomy, you know how to triangulate. It’s easy. When you’re going after other surgical procedures, sometimes the incision’s in the wrong spot and you got to put another incision in. You end up with more than four or five spots that have been incised. That’s the issue here. No matter, I mean, there’s a lot of flexibility where you put the trocar with our system. There’s only one arm going in. You don’t have to guess. We have full ability to move around and look everywhere. With the other ones, depending on even where you put the trocars, the arms can bump into each other on the outside. You don’t have that issue with ours because there’s only one arm. They can’t bump into one arm. The two arms that do the work are on the inside of the abdomen.

Everything that they did in the design here was based on the Chief Medical Officer. He’s one of the founders. He’s a surgeon. He’s been doing this for a long time. He was one of the first to adopt the da Vinci. He teaches younger surgeons how to use it. He loves it. He does. He saw the limitations, and that was the whole impetus of this company.

Unidentified speaker, Unidentified: Thank you.

Stephen From, CEO, Vicarious Surgical: Okay.

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